五脏俞麦粒灸治疗无痴呆型血管性认知障碍临床观察  

Clinical Observation of Grain-sized Moxibustion at Back-Shu Points of Zang-organs for Vascular Cognitive Impairment-no Dementia

作　　者：倪芳英[1] 李丽萍[2] 

机构地区：[1]杭州市余杭区第二人民医院,杭州311121 [2]杭州市中医院,杭州310007

出　　处：《上海针灸杂志》2018年第2期174-178,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：浙江省杭州市科技发展计划基金项目(2015KJJ14)

摘　　要：目的观察五脏俞麦粒灸治疗髓海不足型无痴呆型血管性认知障碍(VCIND)的临床疗效与作用机制。方法将92例髓海不足型VCIND患者随机分为麦粒灸组、电针组、西药组,麦粒灸组、电针组各脱落1例,有效纳入患者共90例,每组30例。主穴取心俞、肾俞,配穴取顶中线、额中线、顶旁1线、足三里、三阴交、悬钟、太溪。麦粒灸组与电针组于心俞、肾俞穴分别施麦粒灸法与电针法,余配穴采取常规针刺治疗。每日治疗1次,每星期连续治疗5 d,4星期为1个疗程,共治疗2个疗程。西药组口服吡拉西坦片,每次0.4 g,每日3次,连续治疗8星期。8星期后比较3组患者临床疗效、蒙特利尔认知评估量表(Mo CA)评分、日常生活活动能力评定量表(ADL)评分及血清同型半胱氨酸(Hcy)和叶酸含量。结果麦粒灸组总有效率为86.7%(26/30),优于电针组63.3%(19/30)及西药组36.7%(11/30)(P<0.05,P<0.01)。3组患者治疗后Mo CA评分、ADL评分及血清Hcy和叶酸含量均较治疗前有明显改善(P<0.01),且麦粒灸组显著优于电针组和西药组(P<0.05,P<0.01),电针组优于西药组(P<0.05)。结论五脏俞麦粒灸治疗髓海不足型VCIND疗效显著,其对髓海不足型VCIND的治疗作用可能通过降低血Hcy水平及升高血叶酸含量实现。Objective To observe the clinical efficacy and action mechanism of grain-sized moxibustion at Back- Shu points of Zang-organs in treating vascular cognitive impairment-no dementia （VCIND） due to marrow insufficiency. Method Ninety-two patients with VCIND due to marrow insufficiency were randomized into a grain-sized moxibustion group, an electroacupuncture group and a Western medication group. Since the grain-sized moxibustion group and electroacupuncture group each had 1 dropout case, there were 90 valid recruited cases, 30 in each group. Xinshu （BL15） and Shenshu （BL23） were selected as the major points, with Middle Line of Vertex （MS5）, Middle Line of Forehead （MS1）, Lateral Line 1 of Vertex （MS8）, Zusanli （ST36）, Sanyinjiao （SP6）, Xuanzhong （GB39） and Taixi （KI3） as the adjunct points. The grain-sized moxibustion group and electroacupuncture group respectively received grain-sized moxibustion and electroacupuncture at Xinshu and Shenshu, and the adjunct points were treated with ordinary acupuncture. The intervention was given once a day, successive 5 d a week, and 4 weeks as a course of treatment, for 2 courses in total. The Western medication group was prescribed with oral administration of Piracetam tablet, 0.4 g per dose, 3 times a day, for successive 8 weeks. The clinical efficacies, Montreal Cognitive Assessment （MoCA） and Activities of Daily Living （ADL） scores, homocysteine （Hcy） and folic acid contents in serum were compared among the three groups after 8 weeks. Result The total effective rate was 86.7% （26/30） in the grain-sized moxibustion group, superior to 63.3% （19/30） in the electroacupuncture group and 36.7% （11/30） in the Western medication group （P〈0.05,P〈0.01）. The MoCA and ADL scores and serum contents of Hcy and folic acid were significantly improved after the treatment in the three groups （P〈0.01）, and the grain-sized moxibustion group was significantly better than the electroacupuncture group and Western

关 键 词：认知障碍 麦粒灸 电针 头针刺激区 五脏俞 Mo CA评分 ADL评分 血清HCY 

分 类 号：R246.6[医药卫生—针灸推拿学]